Billing & Claims Specialist
Company: Elderwood Health Plan
Posted on: September 10, 2021
Join Our Team: Join our strong and growing company today!
Health Plan, a managed medicaid provider plan, is seeking a
Billing/Claims Specialist to provide administrative support
to the department by assisting with processing and resolving
invoices based on state rejections and delinquent accounts,
conducting audits, and submitting monthly billing to the state and
monthly spenddown invoices to members. This individual communicates
with clients and providers regularly.
- Generates and submits monthly
roster of invoices to state for payment
- Generates and distributes
monthly Spenddown and NAMI invoices to members with balance
- Manages the outstanding Accounts
Receivable for both Medicaid Capitation Payments and
- Troubleshoots Medicaid
Capitation Payments that denied or paid in errors.
- Connects with members who are
delinquent in payment.
- Assists providers with inquiries
in an efficient and timely fashion.
- Provides superior customer
- Completes audits as directed for
Member Medicaid Recertification, missing required documentation
(CDPAP Orders, etc)
- Utilizes electronic timekeeping
system as directed.
- Supports and abides by
Elderwood’s Mission, Vision, and Values.
- Abides by Elderwood’s businesses
code of conduct, compliance and HIPAA policies.
- Performs other duties as
assigned by supervisor, management staff or
- Minimum of Associates degree in
Billing, Business or related field
- Minimum two (2) years of medical
billing/collections experience (long term care or health insurance
- Minimum one (1) year customer
- Demonstrated telephone customer
service experience desired
- Demonstrated proficiency with
Microsoft Office programs including Excel, Word and
- Prior experience working with
third party payors preferred
Elderwood expects all current and new
employees to be vaccinated against COVID-19. If hired, you will be
required to provide proof of vaccination. Employees may
request a medical exemption from vaccination.
Employee Perks!: 401K Retirement Plan with Company Match, Clean,
Neat & Newly Renovated Facility, Close to thruway entrances/exits,
Conveniently located on a bus route, Free On-Site Parking, Life
Insurance, Medical, Dental, and Vision insurance, Point-earning
employee reward program: redeem for prizes!, Relaxing employee
lounge with free iced/hot coffee, Strong leadership, Substantial
employee referral program EOE Statement: WE ARE AN EQUAL
OPPORTUNITY EMPLOYER. Applicants and employees are considered for
positions and are evaluated without regard to mental or physical
disability, race, color, religion, gender, national origin, age,
genetic information, military or veteran status, sexual
orientation, marital status or any other protected Federal,
State/Province or Local status unrelated to the performance of the
Keywords: Elderwood Health Plan, Tonawanda , Billing & Claims Specialist, Other , Tonawanda, New York
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